Study finds cognitive behavioral therapy is cost-effective

Cognitive behavioral therapy (or CBT) delivered in a primary care setting is a cost-effective way to treat adolescents with depression who decline or quickly stop using antidepressants, according to a Kaiser Permanente study published today in the journal Pediatrics.

This work builds upon previous research, also published in Pediatrics, showing that CBT improved time to diagnostic recovery from major depression for teenagers who received CBT in their primary care clinic. Participants who received CBT learned how to modify their behaviors, challenge their unrealistic and negative beliefs, and think more positively.

Depression is a widespread and costly health problem in the U.S., with one estimate placing the total economic burden of depression at more than $210 billion annually. Among adolescents, the prevalence of depression is on the rise. Antidepressant medications are the usual course of treatment for adolescents diagnosed with depression, but as many as half of families with a depressed child choose not to begin antidepressant therapy. And among those who do begin treatment, nearly half do not continue, for reasons including side effects, lack of benefit and cost.

"Untreated or undertreated depression is a serious burden for many adolescents and their families, and the impact is often felt for many years after diagnosis," said John Dickerson, PhD, a health economist at the Kaiser Permanente Center for Health Research and lead author of the new publication. "Now we have evidence that CBT is not only clinically effective, but cost-effective as well. This is good news for patients, their families and health care systems."

In their new analysis, the study team showed that over a two-year period, depression-related health care costs for adolescents who received CBT were about $5,000 less on average than depressed adolescents in the control group, who received usual care without CBT.

Researchers examined depression-related costs from a societal perspective, meaning they accounted for costs experienced by patients and their families in addition to the costs borne by the health care system. In addition to the cost of delivering the CBT intervention to patients, researchers examined the cost of mental health-related inpatient hospital stays, a wide variety of medical and mental health services, and the time that parents spent taking their children to services, among other factors.

The study, which included 212 adolescents who received care in Kaiser Permanente primary care clinics in Oregon and Washington, showed that a CBT intervention can be brief and still deliver long-term benefits in terms of cost and clinical outcomes.

"Most other studies of CBT for depressed youths that we looked at involved a much longer treatment program than the one we tested," Dickerson explained. "We chose to test a 'lean' model with a smaller number of CBT sessions because such a model is more likely to be adopted by health care organizations. It's important for health systems and families to know that a brief CBT program is likely to improve mental health outcomes for depressed adolescents who decline antidepressants, and is also likely to be cost-effective over time."

Related Stories

According to a national register study comparing Finnish birth cohorts from 1987 and 1997, an increasing number of adolescents receive a psychiatric or neurodevelopmental diagnosis. The number of diagnosed adolescents increased ...

Depression is one of the most common mental health issues a teenager can face. According to the National Institute of Mental Health, an estimated 2.8 million adolescents ages 12 to 17 in the U.S. had at least one major depressive ...

Depressed teenagers who received cognitive behavioral therapy in their primary care clinic recovered faster, and were also more likely to recover, than teens who did not receive the primary care-based counseling, according ...

How best to care for the many adolescents who have depression? In a collaborative care intervention, a care manager continually reached out to teens—delivering and following up on treatment in a primary-care setting (the ...

While most adolescents with newly identified depression symptoms received some treatment within three months, some of them did not receive any follow-up care and 40 percent of adolescents prescribed antidepressant medication ...

Brief psychological interventions delivered by lay counsellors in primary care were effective and cost-effective for patients with depression and harmful drinking in India, according to two studies in PLOS Medicine by Vikram ...

Recommended for you

Western Sydney University research has found that first-time mothers with mental health issues – in particular, maternal anxiety – are five times as likely to have their baby noted as having reflux when admitted to hospital.

An analysis of trends in sudden unexpected infant death (SUID) over the past two decades finds that the drop in such deaths that took place following release of the 1992 American Academy of Pediatrics (AAP) "back to sleep" ...

A team of researchers affiliated with the Dartmouth Institute for Health Policy and Clinical Practice has found evidence suggesting that newborn babies addicted to opioids do better when they are kept in hospital rooms with ...

0 comments

Please sign in to add a comment.
Registration is free, and takes less than a minute.
Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.